REVIEW OF ONE HUNDRED CONSECUTIVE ABDOMINAL HYSTERECTOMIES: SUITABILITY FOR VAGINAL HYSTERECTOMY

Area of Science:

• Gynaecology
• Surgical Procedures
• Patient Outcomes

Background:

• Abdominal hysterectomy is a common gynecological surgery with significant morbidity and slow recovery.
• Vaginal hysterectomy is associated with fewer complications compared to the abdominal approach.
• This study evaluates the potential for converting abdominal hysterectomies to vaginal or laparoscopic procedures.

Purpose of the Study:

• To determine the proportion of abdominal hysterectomies that could be performed vaginally or with laparoscopic assistance.
• To assess the feasibility of alternative surgical routes for hysterectomy.
• To improve patient recovery and reduce surgical complications.

Main Methods:

• Retrospective review of 100 consecutive abdominal hysterectomy case notes.
• Analysis of 85 available case notes for patient demographics, uterine characteristics, and indications.
• Evaluation of surgical outcomes and complications.

Main Results:

• 74 cases of benign disorders were analyzed; 50% of patients were over 40, 82% multiparous.
• Uterine size was <12 weeks in 67 cases; 44.6% had menorrhagia without organic pathology.
• Complications included blood transfusions (3 preop, 7 postop), primary hemorrhage (3), secondary hemorrhage (3), paralytic ileus (2), and intestinal obstruction (1).

Conclusions:

• All patients requiring hysterectomy should be assessed for vaginal hysterectomy, barring contraindications.
• Preoperative assessment under anesthesia is crucial for determining the optimal surgical approach.
• This approach can potentially reduce morbidity and enhance recovery compared to abdominal hysterectomy.